Healthcare Provider Details

I. General information

NPI: 1013837376
Provider Name (Legal Business Name): SUZANNAH HERSCHKOWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 W 15TH ST FL 2
NEW YORK NY
10011-6701
US

IV. Provider business mailing address

90 PINEHURST AVE APT 3C
NEW YORK NY
10033-1704
US

V. Phone/Fax

Practice location:
  • Phone: 212-229-6905
  • Fax: 646-477-4094
Mailing address:
  • Phone: 917-669-8573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132253
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: